Provider Demographics
NPI:1992482087
Name:LEIATAUA, HANNAH MICHELLE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MICHELLE
Last Name:LEIATAUA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HEKILI ST # A406
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2800
Mailing Address - Country:US
Mailing Address - Phone:808-489-3548
Mailing Address - Fax:
Practice Address - Street 1:111 HEKILI ST # A406
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2800
Practice Address - Country:US
Practice Address - Phone:808-489-3548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician